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MSN 570 Advanced Pathophysiology Final 2024
1. When does pain in the lower extremities due to peripheral artery disease usually worsen?
- A. with rest because blood flow decreases.
- B. with elevation of the extremity because blood is diverted away.
- C. when the leg is in a dependent position because blood pools.
- D. when the leg is touched or massaged because cytokines are released.
Correct answer: B
Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.
2. A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:
- A. A normal leukocyte count
- B. A high leukocyte count
- C. A low leukocyte count
- D. Another term for leukopenia
Correct answer: B
Rationale: Leukocytosis refers to an abnormally high leukocyte count. This condition is characterized by an elevated number of white blood cells in the bloodstream. Choice A is incorrect because leukocytosis does not refer to a normal leukocyte count. Choice C is incorrect as leukocytosis is not related to a low leukocyte count. Choice D is incorrect as leukopenia is the opposite of leukocytosis, indicating a low white blood cell count.
3. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following symptoms is consistent with this diagnosis?
- A. Right lower quadrant cramping
- B. Severe bloody diarrhea
- C. Nausea and vomiting
- D. Mostly affects the rectum
Correct answer: A
Rationale: The correct answer is A: Right lower quadrant cramping. Crohn's disease commonly presents with abdominal pain, particularly in the right lower quadrant. Choice B, severe bloody diarrhea, is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Choice C, nausea and vomiting, are not typical symptoms of Crohn's disease. Choice D is incorrect as Crohn's disease can affect any part of the gastrointestinal tract, not just the rectum.
4. A 30-year-old has poorly controlled asthma and is taking prednisone 10 mg by mouth once a day. He has been on this regimen for 6 weeks. Abrupt withdrawal or discontinuation of this medication can cause:
- A. adrenal crisis
- B. hypercortisolism
- C. ACTH stimulation
- D. thyroid crisis
Correct answer: A
Rationale: Abrupt withdrawal or discontinuation of prednisone, a corticosteroid, can lead to adrenal crisis. This occurs due to the suppression of the adrenal glands' natural cortisol production caused by prolonged exogenous steroid administration. Adrenal crisis presents with symptoms such as weakness, fatigue, abdominal pain, and hypotension. Hypercortisolism (Cushing syndrome) results from chronic excessive exposure to cortisol, not abrupt withdrawal. ACTH stimulation would be expected in response to low cortisol levels, not as a direct consequence of prednisone withdrawal. Thyroid crisis (thyroid storm) is associated with severe hyperthyroidism and is not directly related to corticosteroid withdrawal.
5. Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS?
- A. HIV only infects B cells
- B. HIV is a retrovirus
- C. Infection does not require a host cell receptor
- D. After infection, cell death is immediate
Correct answer: B
Rationale: The correct answer is B. HIV is a retrovirus that infects T cells and leads to the gradual destruction of the immune system. Choice A is incorrect because HIV infects T cells primarily, not just B cells. Choice C is incorrect because HIV infection requires host cell receptors for entry. Choice D is incorrect because cell death after HIV infection is not immediate; instead, the virus gradually weakens the immune system over time.
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